Healthcare Provider Details

I. General information

NPI: 1356045298
Provider Name (Legal Business Name): KAILY THI TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 STOCKTON BLVD # 300
SACRAMENTO CA
95817-1337
US

IV. Provider business mailing address

7415 HENRIETTA DR
SACRAMENTO CA
95822-5142
US

V. Phone/Fax

Practice location:
  • Phone: 916-520-2460
  • Fax:
Mailing address:
  • Phone: 916-520-7399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: